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James Morris Academy Programme Lead 19 th March 2010

Alcohol and Older People: Context, issues and the future?. James Morris Academy Programme Lead 19 th March 2010. Aims. Establish existing knowledge and practice Assess the need for a better response to alcohol use amongst the elderly Identify overall approaches

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James Morris Academy Programme Lead 19 th March 2010

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  1. Alcohol and Older People: Context, issues and the future? James Morris Academy Programme Lead 19th March 2010

  2. Aims • Establish existing knowledge and practice • Assess the need for a better response to alcohol use amongst the elderly • Identify overall approaches • Examine the potential role of alcohol and older people’s strategies in addressing these issues

  3. Why look at this? • An ageing population • An under-recognised issue • Alcohol interventions require targeted approaches • Older people have the same right to services as others! • Alcohol policy is ASB driven

  4. Why look at this? • So people can have a dignified and healthy older life Source: Broadway Lodge

  5. Ageing population • 2008 over 65s = 16% of the population • 2033 projection = 23%

  6. An under-recognised issue in policy terms • Not much mention in alcohol or older people’s strategy • Limited specific research and development • Alcohol problems not associated with the elderly: • Focus on ‘binge-drinkers’/ASB • Alcohol use disorders only associated with ‘dependence’ • Alcohol misuse or harm ‘excused’ or hidden

  7. Under-recognised in practitioner terms Dar, 2006

  8. ‘Alcohol use disorders in elderly people: fact or fiction?’Dar 2006 • Alcohol misuse is not always being detected or effectively treated • Negative attitudes and inadequate training of healthcare professionals • Better integrated and outreach services are needed • Older people are as likely to benefit from treatment as younger people

  9. Life changes associated with alcohol misuse in elderly people Dar, 2006

  10. Main alcohol-related admissions for over-65s

  11. Institute of Alcohol studies (IAS) fact sheet: ‘Alcohol and the Elderly’ 2009 • Early-Onset drinkers or ‘Survivors’ those people who have a continuing problem with alcohol which developed in earlier life. Roughly 2/3rds of elderly alcohol misusers. • Late-Onset drinkers or ‘Reactors’begin problematic drinking later in life, often in response to traumatic life events such as the bereavement, loneliness, pain, insomnia, retirement etc. • Intermittent or Binge drinkers– like ‘late-onset drinkers’ will be likely to respond well to alcohol treatment or interventions

  12. IAS fact sheet continued • Alcohol use rising amongst ‘elderly’ (including 45-65s) • Reported health benefits of moderate drinking (such as CVD risk) would apply to the elderly the most • Lower tolerance & drug interactions with alcohol amongst elderly is important • Alcohol misuse masked physically and hidden socially

  13. Best practice approaches? • Need to collect, review and disseminate • Lots of localised services not written about or reviewed? • Hidden data? • Silent helpers? • Non-specific care approaches e.g. healthy ageing programmes, falls services, support for dementia suffers etc.

  14. Identified issues? • Defining ‘older people’ – over 65s only? • The need for better understanding of the prevalence of alcohol use and harms amongst the elderly • The need for better understanding of specific alcohol interventions and treatment • Development of alcohol interventions for the elderly in Primary Care as a key setting (assessing screening tools – MAST-G and FAST have been suggested)

  15. Identified issues cont.? • How alcohol treatment and interventions can better reach older people • Improved knowledge and sharing of existing best practice approaches • Exploration of key issues e.g: • separate recommended consumption guideline? • the role of training for carers? • A better policy recognition of alcohol issues amongst the elderly in both alcohol and older people’s national strategy and related agendas

  16. Local experts meeting (south of England) – February 2009 • The Academy recently facilitated a London roundtable discussion to discuss what proposals could be taken to policy makers • Attendees included: • Dr Tony Rao – Southwark Older People’s Dual Diagnosis service • Dr Karim Dar, Consultant Psychiatrist • Specialist alcohol and older people practitioners from Foundation 66 and CASA • Other specialist areas including housing, dementia, academia, alcohol strategy etc.

  17. Local experts meeting – recommendations to policy leads? • That the inter-face and collaborative working between alcohol, elderly and other relevant services (statutory and not) needed improvement and increasing recognition • A consensus on the best screening tools/approaches was needed, then adopted within specific cross-agency training • Developing separate guidelines for the elderly should be investigated • A specific approach may be required for ‘young olds’ ranging from 50-65

  18. Further info& contacts www.alcoholacademy.net www.alcoholpolicy.net James Morris, AERC Alcohol Academy james@alcoholacademy.net 0207 450 2930

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